International journal of emergency medicine
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The specialty of emergency medicine is in its infancy state in the long history of the Indian health sciences education system. Little analytical published data is available at the moment in India regarding the quality of medical education as perceived by the students. Roff et al. (Med Teach 19: 295-299, 1997) developed a methodology using a Delphi panel to standardize the measurement of medical education known as the Dundee Ready Education Environment Measure (DREEM), which is widely utilized. The purpose of this survey is to investigate student perceptions of medical education environment among emergency medicine residents of an academic medical centre in Northern India using the DREEM tool. ⋯ The DREEM score is a universal tool for assessment of education provided by health science institutes. With a total score of 139.8, the study conducted at our institute showed comparable results to the original DREEM study conducted by Roff et al. The good scores in all the five subscales reveal an excellent educational programme and learning environment as perceived by the students enrolled at our institution.
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This study aims to remodel the Broselow Pediatric Emergency Tape for the Indian pediatric population. The Broselow tape overestimates the heights of the Indian pediatric population and remits inaccurate predicted weights for all color zones with varying degrees and could result in overresuscitation of Indian children in emergency settings. The Indian children are underweight for their age and height. ⋯ A remodeled Broselow tape can predict weights with higher accuracy in the Indian pediatric population.
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Unplanned re-attendance at the Emergency Department (ED) is often monitored as a quality indicator of the care accorded to patients during their index ED visit. High bed occupancy rate (BOR) has been considered as a matter of reduced patient comfort and privacy. Most hospitals in Singapore operate under BORs above 85 %. This study aims to explore factors associated with the unplanned 3-day ED re-attendance rate and, in particular, if higher BOR is associated with higher 3-day unplanned ED re-attendance rate. ⋯ A study using time series data has been conducted to explore the factors associated with the unplanned 3-day ED re-attendance rate. Strong day-of-week effect was first reported. The association between BOR and the ED re-attendance rate varied with hospital.
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Russia's national healthcare system is undergoing significant changes. Those changes which affect healthcare financing are particularly vital. As has often been the case in other nations, the emergency care field is at the forefront of such reforms. ⋯ Preliminary data stemming from their operation have supported a positive effect on efficiency of hospital bed utilization and on appropriate use of specialists and specialized hospital departments. In the pre-hospital domain, there has been a reduction of specialized ambulance types and of the number of physicians staffing all ambulances in favor of midlevel providers. Still, a debate continues at all levels of the medical hierarchy regarding the correct future path for emergency care in Russia with regard to adaptation and sustainability of any foreign models in the context of the country's unique national features.
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Ventilation monitoring practice for intubated pediatric patients with severe traumatic brain injury (TBI) during interfacility transport (IFT) has not been well documented. We describe the difference of practices in ventilation monitoring during IFT from the perspective of a level I pediatric trauma center with an enormous catchment area. ⋯ Non-specialized ground IFT teams did not reliably monitor ventilation in intubated severe pediatric TBI patients. Blood gas monitoring was not a ubiquitous practice for either team. Optimal ventilation monitoring strategies for severe pediatric TBI may require both blood gas and end-tidal monitoring.